Provider Demographics
NPI:1558326579
Name:EISEN, MORRIS M (DO)
Entity Type:Individual
Prefix:
First Name:MORRIS
Middle Name:M
Last Name:EISEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:114 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1022
Mailing Address - Country:US
Mailing Address - Phone:856-772-9600
Mailing Address - Fax:856-772-9650
Practice Address - Street 1:2301 E EVESHAM RD
Practice Address - Street 2:SUITE 406
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4501
Practice Address - Country:US
Practice Address - Phone:856-772-9600
Practice Address - Fax:856-772-9650
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB38543208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00633440OtherRAILROAD MEDICARE
NJ3911101Medicaid
NJ631322Medicare PIN
NJC54051Medicare UPIN